Individual provider Active NPI

Michael Gary Watson, APRN, FNP-BC

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1962473462
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
607206 Issued in TX
Practice address
800 East Dawson Street
Emergency Department
Tyler, TX 75701
Phone
(903) 593-8441
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 607206 TX Primary

Addresses

Primary practice location

800 East Dawson Street
Emergency Department
Tyler, TX 75701

Mailing address

1000 Pine St
Emergency Department
Texarkana, TX 75501-5100
Phone (903) 798-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080304000645 TX Practitioner - Nurse Practitioner 3577648310 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 593-8441

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
607206TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Texas Emergency Physicians, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Jun 7, 2021 Accepting new patients
Christus Trinity Clinic Texas Current Accepting new patients
Texarkana Emergency Physicians PLLC CurrentSince Apr 7, 2014 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jun 7, 2021 Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Camino Real Emergency Physicians PLLC Past Accepting new patients

Locations

1509 State Highway 19 S
Athens, TX 75751
Phone (903) 606-4262

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

2001 N Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 434-8044

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1962473462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PINE ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015100",
            "telephone_number": "903-798-8880",
            "fax_number": "903-798-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 EAST DAWSON STREET",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-593-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MICHAEL",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "607206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.